The number of patients with atrial fibrillation continues to rise, partly because of the increasing size and age of the population but also because of the large number of patients surviving with other potentially arrhythmogenic conditions.1 Atrial fibrillation has been shown to be an independent predictor of mortality with odds ratio of 1.5 (95% confidence interval 1.2 to 1.8) in men and 1.9 (95% confidence interval 1.6 to 2.3) in women.2 Restoring sinus rhythm is more important than a rate control strategy in persistent atrial fibrillation, and most patients should be offered the chance to have normal rhythm restored.